1,2-Diphosphonio-diphosphirane / 1,2-Diphosphonio-diphosphiranes

The addition of AlCl3, to a dichloromethane solution of a triphosphenium tetrachloroaluminate R3P-P-PR3 AICI4 leads to chloromethylation of the latter, and in a subsequent reaction to the formation of 1,2-diphosphonio-diphosphirane tetrachloroalum inates. It is essential for this second step, that at least one R3P group of the two triphosphenium ions entering the reaction is aminosubstituted. The structure o f the diphosphonio-diphosphirane ions is established by NMR spectroscopy and in one case by X-ray investigation

B cell autophagy mediates TLR7-dependent SLE and controls extramedullary hematopoiesis (BA4P.217)

Systemic Lupus Erythematosus (SLE) is a heterogeneous disease, defined by a loss of B cell self-tolerance resulting in the production of autoantibodies. One of the many mechanisms described resulting in a break in B cell self-tolerance is overexpression of the endosomal toll-like receptor, TLR7. We hypothesized that autophagy plays a crucial role in TLR7 activation in B cells by delivering ligand to endosomes. To test this model, we produced TLR7 transgenic (tg) mice with a B cell-specific (CD19-cre) ablation of autophagy (ATG5 ko), and compared SLE development to that of TLR7 tg mice with intact autophagy machinery. We observed that loss of ATG5 in B cells significantly increased the survival of TLR7 tg mice, reduced serum IgG and anti-nuclear autoantibodies, thereby preventing glomerulonephritis. These data suggest that B cell autophagy is required for TLR7-mediated SLE disease progression. However, while symptoms of SLE were ameliorated, extramedullary hematopoiesis (EMH) was dramatically increased with a splenic red pulp expansion in these mice. Thus, autophagy in B cells plays an important role in controlling lineage determination in hematopoiesis, likely by regulating chemokine and cytokine production, the mechanism by which is currently under investigation. A better understanding of the control steps involved in TLR7 activation and cytokine production could lead to improved therapeutics for treatment of SLE.

Effekte von Topiramat bei Patienten mit Epilepsie und intellektueller Beeinträchtigung

There is little knowledge about the effects of topiramate in intellectually impaired epileptic patients. This open prospective study compares seizure frequencies during a 3-month period of topiramate add-on therapy (after 3 months of titration) compared with a 3-month baseline period. An intention-to-treat analysis was made on the first 24 consecutive topiramate-treated adult patients (residents of the Bethel epilepsy centre, therapy-resistant epilepsy, intellectual impairment of different degrees, one half with neurological deficits). The responder rate (at least a 50% reduction in seizure frequency) was 37.5%. One patient became completely seizure-free during post-evaluation (up to 24 months). Efficacy was not different between different epileptic syndromes or seizure types (case number too small). Responders had topiramate dosages above 200 mg/day and serum concentrations above 2.2 micrograms/ml. Six patients (25%) experienced serious neuropsychiatric complications such as confusion and severe deceleration of thinking and acting, up to complete helplessness (at topiramate dosages from 50 mg/day to 900 mg/day and serum concentrations from 2.2 micrograms/ml to 8.0 micrograms/ml). Preexisting brain damage may enhance the risk of unwanted central nervous effects.

Revealing biogenic sulfuric acid corrosion in sludge digesters: detection of sulfur-oxidizing bacteria within full-scale digesters

Biogenic sulfuric acid corrosion (BSA) is a costly problem affecting both sewerage infrastructure and sludge handling facilities such as digesters. The aim of this study was to verify BSA in full-scale digesters by identifying the microorganisms involved in the concrete corrosion process, that is, sulfate-reducing (SRB) and sulfur-oxidizing bacteria (SOB). To investigate the SRB and SOB communities, digester sludge and biofilm samples were collected. SRB diversity within digester sludge was studied by applying polymerase chain reaction-denaturing gradient gel electrophoresis (PCR-DGGE) targeting the dsrB-gene (dissimilatory sulfite reductase beta subunit). To reveal SOB diversity, cultivation dependent and independent techniques were applied. The SRB diversity studies revealed different uncultured SRB, confirming SRB activity and H2S production. Comparable DGGE profiles were obtained from the different sludges, demonstrating the presence of similar SRB species. By cultivation, three pure SOB strains from the digester headspace were obtained including Acidithiobacillus thiooxidans, Thiomonas intermedia and Thiomonas perometabolis. These organisms were also detected with PCR-DGGE in addition to two new SOB: Thiobacillus thioparus and Paracoccus solventivorans. The SRB and SOB responsible for BSA were identified within five different digesters, demonstrating that BSA is a problem occurring not only in sewer systems but also in sludge digesters. In addition, the presence of different SOB species was successfully associated with the progression of microbial corrosion.

Autophagy: a dichotomous player in Toll-like receptor 7-mediated autoimmunity. (P4073)

The endosomal Toll-like receptor, TLR7, acts as critical line of defense against viral pathogens; however, overexpression of TLR7 has been shown to lead to spontaneous lupus-like disease (SLE). Thus, tight regulation of this pattern recognition receptor is crucial in preventing a hyperactive cellular state. We hypothesized that autophagy plays a role in TLR7 activation by delivering ligand to endosomes and by controlling subsequent inflammatory responses. To test this model, we crossed TLR7 transgenic (tg) mice that succumb to SLE with mice where ATG5, a critical autophagy gene, was deleted in dendritic cells (DCs) or B cells or both. These mice were compared to TLR7 tg mice with intact autophagy for morbidity and the inflammatory response. We observed that loss of ATG5 in either DCs or B cells significantly increased the survival of TLR7 tg mice, while ATG5 deletion in both cell types only modestly improved survival. On the other hand, loss of autophagy led to an elevated inflammatory response compared to TLR7 tg mice with intact autophagy, as evidenced by vastly increased lymphoid organ mass and elevated numbers of granulocytes and macrophages. The inflammatory mediators involved in this process are currently under investigation. These data suggest that autophagy plays an important and dichotomous role in TLR7-mediated autoimmunity, both enabling and ameliorating symptoms of SLE. It is likely that autophagy is affecting multiple TLR7-dependent signaling processes.

Evidence for strong van der Waals type Rydberg-Rydberg interaction in a thermal vapor

We present evidence for Rydberg-Rydberg interaction in a gas of rubidium atoms above room temperature. Rabi oscillations on the nanosecond time scale to different Rydberg states are investigated in a vapor cell experiment. Analyzing the atomic time evolution and comparing to a dephasing model, we find a scaling with the Rydberg quantum number n that is consistent with van der Waals interaction. Our results show that the interaction strength can be larger than the kinetic energy scale (Doppler width), which is the requirement for realization of thermal quantum devices in the GHz regime.

Ultrafast charge localization in a stripe-phase nickelate

Self-organized electronically ordered phases are a recurring feature in correlated materials, resulting in, for example, fluctuating charge stripes whose role in high-TC superconductivity is under debate. However, the relevant cause-effect relations between real-space charge correlations and low-energy excitations remain hidden in time-averaged studies. Here we reveal ultrafast charge localization and lattice vibrational coupling as dynamic precursors of stripe formation in the model compound La(1.75)Sr(0.25)NiO4, using ultrafast and equilibrium mid-infrared spectroscopy. The opening of a pseudogap at a crossover temperature T* far above long-range stripe formation establishes the onset of electronic localization, which is accompanied by an enhanced Fano asymmetry of Ni-O stretch vibrations. Ultrafast excitation triggers a sub-picosecond dynamics exposing the synchronous modulation of electron-phonon coupling and charge localization. These results illuminate the role of localization in forming the pseudogap in nickelates, opening a path to understanding this mysterious phase in a broad class of complex oxides.

Soil nitrogen dynamics in a river floodplain mosaic

In their natural state, river floodplains are heterogeneous and dynamic ecosystems that may retain and remove large quantities of nitrogen from surface waters. We compared the soil nitrogen dynamics in different types of habitat patches in a restored and a channelized section of a Thur River floodplain (northeast Switzerland). Our objective was to relate the spatiotemporal variability of selected nitrogen pools (ammonium, nitrate, microbial nitrogen), nitrogen transformations (mineralization, nitrification, denitrification), and gaseous nitrogen emission (NO) to soil properties and hydrological processes. Our study showed that soil water content and carbon availability, which depend on sedimentation and inundation dynamics, were the key factors controlling nitrogen pools and processes. High nitrogen turnover rates were measured on gravel bars, characterized by both frequent inundation and high sediment deposition rates, as well as in low-lying alluvial forest patches with a fine-textured, nutrient-rich soil where anaerobic microsites probably facilitated coupled nitrification-denitrification. In contrast, soils of the embankment in the channelized section had comparatively small inorganic nitrogen pools and low transformation rates, particularly those related to nitrate production. Environmental heterogeneity, characteristic of the restored section, favors nitrogen removal by creating sites of high sedimentation and denitrification. Of concern, however, are the locally high NO efflux and the possibility that nitrate could leach from nitrification hotspots.

[Burnout. Can it be measured?]

Burnout is widely known as a work-related syndrome that is associated by serious individual and social consequences. The aim of the HTA report "Differential diagnostic of the burnout syndrome" published by DIMDI in 2010 was to determine how burnout can be diagnosed and distinguished from other disorders. Based on a systematic literature review of 36 databases, 852 studies published between 2004 and 2009 were identified. After considering inclusion and exclusion criteria, 25 medical and one ethical study remained. The study evidence is predominantly low. Self-assessment tools are mainly used. The analysis showed that no standardized, common valid procedure exists to obtain a burnout diagnosis. Overall the problem is to measure a phenomenon that is not exactly defined. It is primarily important to distinguish burnout from depression, alexithymia, feeling unwell, and the concept of prolonged exhaustion. Beside the need for a valid definition, further research is needed, particularly high-quality, long-term studies, to broaden the understanding of the syndrome. Furthermore, a standardized, internationally accepted and valid procedure for diagnosing burnout is necessary.

Personalised iron supply for prophylaxis and treatment of pregnant women as a way to ensure normal iron levels in their breast milk

RATIONALE

Because the characteristics of all body fluids depends on patient's health status, is it possible that disadvantaged and socially vulnerable mothers may have lower amounts of iron in their breast milk, and that their babies receive lower content of the mineral for their normal growth and development. Assuring a preventive treatment of the mother might solve this problem.

OBJECTIVE

To demonstrate breast milk iron content from disadvantaged mothers and impact of personalized iron supplementation program.

MATERIALS AND METHODS

cross-sectional study. Breast milk samples were obtained for ferritin analysis. Health's services usually provides free folic acid and iron treatment however, treatment compliance is low. Patients were random in two groups: "A: Controls" that had free iron tablets available from Health Centre; and "B: Intervention" group where patients accepted to be periodically contacted at home by health's team for personalized iron dispensation.

RESULTS

360 patients were included. Profilaxis and treatment compliance were 100% and 97,6% for B group while for "Control" one was 63% and 34%(p0.0001). Higher breast milk iron levels were detected in Intervention's mothers compared with control's patients (p0.007).

CONCLUSION

Personalized iron prophylaxis and treatment increased breast milk iron levels. Public health policy must ensure iron dispensation for each underserved mother in order to reduce children problems associate to iron deficiency during the first year of their life.

GHz Rabi flopping to Rydberg states in hot atomic vapor cells

We report on the observation of Rabi oscillations to a Rydberg state on a time scale below 1 ns in thermal rubidium vapor. We use a bandwidth-limited pulsed excitation and observe up to 6 full Rabi cycles within a pulse duration of ∼4  ns. We find good agreement between the experiment and numerical simulations based on a surprisingly simple model. This result shows that fully coherent dynamics with Rydberg states can be achieved even in thermal atomic vapor, thus suggesting small vapor cells as a platform for room-temperature quantum devices. Furthermore, the result implies that previous coherent dynamics in single-atom Rydberg gates can be accelerated by 3 orders of magnitude.

Exogenous and endogenous virus interactions in head and neck cancer immunity (105.34)

We report that two common tumor viruses etiologically associated with head and neck cancer, Epstein-Barr virus (EBV) with undifferentiated nasopharyngeal carcinoma, and human papillomavirus (HPV) with oropharyngeal squamous cell carcinoma, transactivate an endogenous retrovirus (HERV-K18), which encodes a superantigen that activates TCRBV13 T cells. EBV LMP-2 transactivated the HERV-K18 superantigen in nasopharyngeal epithelial cells, and EBV-associated nasopharyngeal carcinomas expressed the superantigen. HPV type-16 E6 and E7 proteins also transactivated the HERV-K18 superantigen in oropharyngeal epithelial cells, and superantigen expression was significantly increased in HPV16-associated carcinomas. Serum cytokine levels in head and neck carcinoma patients indicated that there were distinct inflammatory profiles associated with exogenous and endogenous viruses. HPV-associated patients had increased levels of serum IL-8, while HPV-negative patients had higher serum IL-6 and G-CSF levels. Interestingly, HERV-K18 superantigen levels correlated independently with serum levels of the Th2 cytokine IL-13. Among HPV+ tumors, gene expression array analyses indicated that B cell specific genes were significantly upregulated in the superantigen high group. Our results suggest that endogenous superantigen expression in HPV+ tumors was associated with a Th2 immune response, demonstrating that chronic and endogenous viruses comprising the virome affect both host and tumor immunity.

Consensus guidelines into the management of epilepsy in adults with an intellectual disability

BACKGROUND

Epilepsy has a pervasive impact on the lives of people with intellectual disability and their carers. The delivery of high-quality care is impacted on by the complexity and diversity of epilepsy in this population. This article presents the results of a consensus clinical guideline process.

RESULTS

A Delphi process identified a list of priority areas for the development of evidence-based guidelines. All guidelines were graded and consensus on scoring was achieved across the guideline group.

CONCLUSION

There is a dearth of high-quality evidence from well-constructed studies on which to base guidance. However, the development of internationally derived consensus guidelines may further support the management of epilepsy in adults with an intellectual disability.

ABC-transporter gene-polymorphisms are potential pharmacogenetic markers for mitoxantrone response in multiple sclerosis

Escalation therapy with mitoxantrone (MX) in highly active multiple sclerosis is limited by partially dose-dependent side-effects. Predictors of therapeutic response may result in individualized risk stratification and MX dosing. ATP-binding cassette-transporters ABCB1 and ABCG2 represent multi-drug resistance mechanisms involved in active cellular MX efflux. Here, we investigated the role of ABC-gene single nucleotide polymorphisms (SNPs) for clinical MX response, corroborated by experimental in vitro and in vivo data. Frequencies of ABCB1 2677G>T, 3435C>T and five ABCG2-SNPs were analysed in 832 multiple sclerosis patients (Germany, Spain) and 264 healthy donors. Using a flow-cytometry-based in vitro assay, MX efflux in leukocytes from individuals with variant alleles in both ABC-genes (designated genotype ABCB1/ABCG2-L(ow), 22.2% of patients) was 37.7% lower than from individuals homozygous for common alleles (ABCB1/ABCG2-H(igh), P < 0.05, 14.8% of patients), resulting in genotype-dependent MX accumulation and cell death. Addition of glucocorticosteroids (GCs) inhibited MX efflux in vitro. ABC-transporters were highly expressed in leukocyte subsets, glial and neuronal cells as well as myocardium, i.e. cells/tissues potentially affected by MX therapy. In vivo significance was further corroborated in experimental autoimmune encephalomyelitis in Abcg2(-/-) animals. Using a MX dose titrated to be ineffective in wild-type animals, disease course and histopathology in Abcg2(-/-) mice were strongly ameliorated. Retrospective clinical analysis in MX monotherapy patients (n = 155) used expanded disability status scale, relapse rate and multiple sclerosis functional composite as major outcome parameters. The clinical response rate [overall 121 of 155 patients (78.1%)] increased significantly with genotypes associated with decreasing ABCB1/ABCG2-function [ABCB1/ABCG2-H 15/24 (62.5%) responders, ABCB1/ABCG2-I(ntermediate) 78/98 (79.6%), ABCB1/ABCG2-L 28/33 (84.8%), exact Cochran-Armitage test P = 0.039]. The odds ratio for response was 1.9 (95% CI 1.0-3.5) with each increase in ABCB1/ABCG2 score (from ABCB1/ABCG2-H to -I-, and -I to -L). In 36 patients with severe cardiac or haematological side effects no statistically relevant difference in genotype frequency was observed. However, one patient with biopsy proven cardiomyopathy only after 24 mg/m2 MX exhibited a rare genotype with variant, partly homozygous alleles in 3 ABC-transporter genes. In conclusion, SNPs in ABC-transporter genes may serve as pharmacogenetic markers associated with clinical response to MX therapy in multiple sclerosis. Combined MX/GC-treatment warrants further investigation.

Norrie-Warburg syndrome: two novel mutations in patients with classical clinical phenotype

Norrie-Warburg syndrome (NWS) is a rare X-linked disorder characterized by blindness, which is invariable, deafness and mental disturbances, which are present occasionally. We describe here two novel mutations, a missense mutation (C126S) and a 1-base pair insertion (insT466/T467), together with a recurrent mutation (M1V), found in patients presenting with the classical clinical phenotype of NWS. All three mutations are likely to result in prominent structural changes of the norrin protein.